Cancer patient in limbo while bill is disputed

MICHAEL OLESKER

November 15, 1990|By MICHAEL OLESKER

Judy Marsh should have been in a hospital by now. Instead, she's in limbo. The doctors say she gets immediate treatment for cancer or the end is near. But health insurers say they'll cover her, and then they say they won't, and the clock keeps ticking away Marsh's time.

It shouldn't end like this for anybody, with money coming between life and death. For Marsh, it's been a two-year battle. First, the diagnosis of breast cancer. Then the chemotherapy and the hope for remission. Then, last June, the metastasis in a lung.

At University Hospital, they told her of a new treatment, something called an autologous bone marrow transplant, where they'd take healthy bone marrow out of her, freeze it, then give her high doses of chemotherapy, the equivalent of five months of it in just four days.

The idea is to burn up the remaining bone marrow in her body -- and with it, all the cancer cells. Then they'd infuse the bone marrow they'd frozen back into her system, and let it regenerate.

"The doctors say it's my only chance for a cure," Marsh, 49, said yesterday, trying to sound perky with time running out. "Without it, they gave me six months. That was in July. I said, 'Let's get started.' "

The doctors told her to go to Duke University Hospital, where they're getting hopeful results with the new procedure. But Duke sent a letter with a chilling message: They wanted a certified check for $96,000, to be handed over at admission, and another $56,000 due when she was discharged.

The cost was breathtakingly prohibitive, but Marsh and her husband, Roland, who'd retired from his federal government job the week before his wife's original cancer diagnosis, had hopes she'd be covered by Blue Cross, through the Federal Employee Program.

On Oct. 17, Duke University Hospital got a letter from Blue Cross of North Carolina. Marsh was covered. The treatment could begin, but first Marsh would have to undergo a couple of weeks of rigorous pretreatment tests to see if there had been any more spread of the cancer: brain and bone and pelvic scans, a bone marrow biopsy, extensive heart tests, stress tests.

"It was rough," Marsh said yesterday, at her Pasadena home, "but I made it."

Not quite. A second letter arrived at Duke on Oct. 31. A hospital administrator called Marsh later that day.

"I have some real bad news for you," the administrator, Linda Bullock, said. "We just got a letter from Blue Cross, saying you're not covered."

The letter read: "The procedure is investigative or experimental. We would have no liability for this service. We apologize for any inconvenience this oversight may have caused you."

"Inconvenience?" Judy Marsh said yesterday. "This is my life they're talking about. I couldn't believe they could do this to anyone. I feel so let down, so betrayed."

She was supposed to enter Duke on Nov. 8. Instead, without the necessary money, she started trying to change health insurers' minds. She reached Representative Tom McMillen's office, where a case worker named Liz Wagner has struggled to get her coverage, but without success.

Earlier this week, Blue Cross announced that 20 percent of its member plans have agreed to underwrite the autologous bone marrow treatment. It was a study at Duke University that led to Blue Cross' decision.

It sounded like a godsend for Marsh, but it wasn't. Blue Cross officials in Washington say they're not the ones holding up coverage, it's the Federal Employee Program. And anyway, says Blue Cross, they're just now kicking the program into gear, and they won't know for some time specifically who will qualify for coverage.

Marsh doesn't have that time. The doctors originally wanted her at Duke on Nov. 8, but the second letter from Blue Cross canceled that just one week before treatment would have begun.

Now there's a new deadline: Next Tuesday.

If she doesn't get the treatment by then, all the tests Marsh underwent last month will mean nothing. She will have to go through all of them again, with all of the pain they bring.

Meanwhile, word of Marsh's plight has spread, and people have reached out helping hands. Roland Marsh's cousin, Diane Blake, auctioned off a week at her Ocean City condominium. From $5 chances, about $30,000 has poured in.

Strangers have sent money in the mail, some as much as $500. (The address is Benefit of Judy Marsh, P.O. Box 118, Pasadena, Md. 21122.) Churches have had special offerings. Cookie's, a Mountain Road restaurant specializing in home cooking, held a spaghetti dinner and raised $10,000.

One woman came to the dinner and asked how much it was. Five dollars, she was told. She wrote a check. It was for $305.

"I get chills when I think about it," Marsh said. "People writing checks for $5, for $4. One little lady on a walker went into the Oakwood Medical Center in Glen Burnie. She heard my sister worked there, and she went up to her and gave her a dollar. Isn't that something? I mean, here are strangers. . . ."

Her voice catches. Friends say Judy Marsh is a woman irrepressibly upbeat. Repeatedly, the doctors have had her counsel other cancer patients not to give up hope. But where do you find your own hope with the clock ticking so quickly?

"All I know," Marsh said, "is that I want to live. And I feel like my body is a time bomb, and it's gonna go off, and it's gonna get me. And first they said they'd help me, and then they said they wouldn't, and now they say they'll help some people, but nobody can tell me if I'll be one of them."